Antimicrobial Resistance as Risk Factor for Recurrent Bacteremia after <i>Staphylococcus</i><i>aureus</i>, <i>Escherichia coli</i>, or <i>Klebsiella</i> spp. Community-Onset Bacteremia

Journal article

International audienceWe investigated links between antimicrobial resistance in community-onset bacteremia and 1-year bacteremia recurrence by using the clinical data warehouse of Europe s largest university hospital group in France. We included adult patients hospitalized with an incident community-onset Staphylococcus aureus, Escherichia coli, or Klebsiella spp. bacteremia during 2017-2019. We assessed risk factors of 1-year recurrence using Fine-Gray regression models. Of the 3, 617 patients included, 291 (8.0%) had >1 recurrence episode. Third-generation cephalosporin (3GC)-resistance was significantly associated with increased recurrence risk after incident Klebsiella spp. (hazard ratio 3.91 [95% CI 2.32-6.59]) or E. coli (hazard ratio 2.35 [95% CI 1.50-3.68]) bacteremia. Methicillin resistance in S. aureus bacteremia had no effect on recurrence risk. Although several underlying conditions and infection sources increased recurrence risk, 3GC-resistant Klebsiella spp. was associated with the greatest increase. These results demonstrate a new facet to illness induced by 3GC-resistant Klebsiella spp. and E. coli in the community setting

Authors: Abbara, S; Guillemot, D; Smith, DRM; Oualydy, SE; Kos, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Centers for Disease Control and Prevention
• Journal: Emerging Infectious Diseases
• Volume: 30
• Issue: 5
• Pages: 974-983
• Publication date: 2024-04-25
• DOI: 10.3201/eid3005.231555
• EISSN: 1080-6059
• ISSN: 1080-6040
• Language: English
• Keywords: Confidence interval; Bacteremia; Antibiotic resistance; Medicine; Antibiotics; Antimicrobial; Staphylococcus aureus; Risk factor; Internal medicine; Escherichia coli; Microbiology; Klebsiella; Hazard ratio; Biology; Bacteria